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Morphological changes in nerve rootlets in patients with cervical radiculopathy assessed using computed tomography
Hiroya Shimauchi-Ohtaki1, Toshiyuki Takahashi2, Manabu Minami2
1Department of Neurosurgery, Gunma University, Maebashi, Japan.
Surgical Neurology International
|September 21, 2022
Summary
Computed tomography myelogram (CTM) reveals characteristic nerve rootlet changes in cervical radiculopathy. This imaging technique aids in defining anatomical and pathological details for surgical planning.
Area of Science:
- Neurosurgery
- Radiology
- Spinal Imaging
Background:
- Cervical radiculopathy diagnosis often lacks detailed nerve rootlet assessment.
- Computed tomography myelogram (CTM) is infrequently used for evaluating nerve rootlet compromise.
Purpose of the Study:
- To assess characteristic morphological changes in cervical nerve rootlets using CTM in patients with radiculopathy.
- To evaluate the utility of CTM in defining pathology for anterior foraminotomy.
Main Methods:
- Analysis of CTMs in 32 cases of cervical radiculopathy.
- Consensus agreement among four neurosurgeons on "significant" contrast-enhanced defects near the intervertebral foramen.
Main Results:
- Observed changes include posterior deviation of ventral rootlets (63%), ventral rootlet meandering (52%), and dorsal rootlet meandering (39%).
- The "rootlet stagnation sign" (abnormal proximal course) was noted in 16% of cases.
Conclusions:
- CTM provides superior definition of cervical nerve root anatomy and pathology.
- CTM enhances understanding of radiological findings impacting cervical roots in radiculopathy patients.
